發(fā)布時(shí)間：2018-04-17 15:41

  本文選題：三才配穴 + 原發(fā)性失眠�。� 參考：《長(zhǎng)春中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:研究三才配穴與非經(jīng)非穴針刺治療原發(fā)性失眠的臨床療效差異,以檢驗(yàn)三才配穴治療失眠療效是否優(yōu)于非經(jīng)非穴,并探討其對(duì)ET和PSQI的影響,指導(dǎo)臨床應(yīng)用。方法:本課題的研究對(duì)象是針灸有效的原發(fā)性失眠患者,研究方法用的是隨機(jī)對(duì)照試驗(yàn)(RCT)。依據(jù)篩選標(biāo)準(zhǔn)納入符合標(biāo)準(zhǔn)的患者72例,采用完全隨機(jī)分組方法分成兩組,三才配穴治療組30例,脫落5例;非經(jīng)非穴治療組30例,脫落7例。治療方法:三才配穴組取百會(huì)、神門(雙)、三陰交(雙),非經(jīng)非穴組取臂佈與肩峰連線中點(diǎn)�；颊呷⊙雠P位,穴區(qū)皮膚常規(guī)消毒,取0.30mm×25mm或0.30mm×40mm毫針針刺所取穴位,并在其旁近心端0.5cm處以0.20mm×13mm毫針加以輔針以助通電,得氣后以SDZ-V型電子針療儀通電,刺激波形為連續(xù)波60Hz,強(qiáng)度以患者耐受為度,留針30min,每天治療1次,5天為1個(gè)療程,療程間隔兩天,共治療5個(gè)療程,治療結(jié)束4周后隨訪。以匹茲堡睡眠質(zhì)量指數(shù)(PSQI)和腦電超慢漲落圖(ET)為觀察指標(biāo),通過采集治療前、治療后、隨訪期三個(gè)時(shí)點(diǎn)相關(guān)療效指標(biāo)的數(shù)據(jù),總結(jié)臨床療效差異關(guān)系。所有數(shù)據(jù)的分析采用SPSS19.0統(tǒng)計(jì)軟件。從而對(duì)比針刺三才配穴和針刺非經(jīng)非穴治療原發(fā)性失眠的組內(nèi)及組間對(duì)ET和PSQI的影響。結(jié)果:(1)PSQI組內(nèi)比較:(1)非經(jīng)非穴組:非經(jīng)非穴組治療前后、治療后與隨訪期PSQI中各因子分和總分進(jìn)行配對(duì)樣本t檢驗(yàn)。統(tǒng)計(jì)結(jié)果顯示各因子分治療前后、治療后與隨訪期皆顯示P0.05,提示治療后與治療前的睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、睡眠效率、睡眠障礙、催眠藥物和日間功能障礙相比沒有顯著差異,說明針刺非經(jīng)非穴對(duì)原發(fā)性失眠患者的睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、睡眠效率、睡眠障礙、催眠藥物和日間功能障礙方面的提高與改善沒有作用,且療效穩(wěn)定。治療前后、治療后與隨訪期總分P0.05,提示差異有統(tǒng)計(jì)意義,非經(jīng)非穴組PSQI指數(shù)總分分值降低。(2)三才配穴組:治療前與治療后三才配穴組PSQI指數(shù)中的各個(gè)因子分和總分采用配對(duì)樣本t檢驗(yàn),統(tǒng)計(jì)結(jié)果均顯示P0.05,有顯著差異,說明針刺三才配穴治療原發(fā)性失眠療效顯著,睡眠質(zhì)量和睡眠效率提高,入睡時(shí)間、睡眠時(shí)間、催眠藥物應(yīng)用、睡眠障礙和日間功能障礙均得以改善,各個(gè)因子分和總分分值降低;治療后與隨訪期PSQI指數(shù)中各因子分和總分進(jìn)行配對(duì)樣本t檢驗(yàn),統(tǒng)計(jì)結(jié)果顯示睡眠質(zhì)量和催眠藥物P0.05,提示治療后與隨訪期的睡眠質(zhì)量和催眠藥物具有遠(yuǎn)期療效;入睡時(shí)間、睡眠效率、睡眠障礙和日間功能障礙P0.05,提示治療后與隨訪期入睡時(shí)間、睡眠效率、睡眠障礙和日間功能障礙療效相當(dāng)。(2)PSQI組間比較兩組治療前、治療后和隨訪期的PSQI各因子分及總分分別進(jìn)行配對(duì)樣本t檢驗(yàn)分析,結(jié)果顯示:睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、睡眠效率、睡眠障礙、催眠藥物、日間功能障礙和總分治療前兩組評(píng)分比較皆顯示P0.05,差異無統(tǒng)計(jì)學(xué)意義,組間皆具有可比性;各因子和總分治療后兩組與隨訪期兩組評(píng)分比較皆顯示P0.05,差異有統(tǒng)計(jì)學(xué)意義,提示三才配穴組優(yōu)于非經(jīng)非穴治療組,針刺三才配穴治療原發(fā)性失眠可以提高睡眠質(zhì)量和睡眠效率,減少入睡時(shí)間,增加總的睡眠時(shí)間,減少催眠藥物的服用,改善睡眠障礙和日間功能障礙,降低各因子的評(píng)分分值和總分,并具有遠(yuǎn)期療效。(1)ET組內(nèi)比較:(1)非經(jīng)非穴組:非經(jīng)非穴對(duì)照組ET組內(nèi)r-氨基丁酸、谷氨酸、5-羥色胺、乙酰膽堿、去甲腎上腺素、多巴胺治療前與治療中、治療中與治療后的檢驗(yàn)結(jié)果經(jīng)配對(duì)樣本t檢驗(yàn)統(tǒng)計(jì),結(jié)果皆顯示P0.05,差異無統(tǒng)計(jì)意義。(2)三才配穴組:三才配穴治療組ET組內(nèi)r-氨基丁酸、谷氨酸、5-羥色胺、乙酰膽堿、去甲腎上腺素、多巴胺治療前與治療中、治療中與治療后的檢驗(yàn)結(jié)果經(jīng)配對(duì)樣本t檢驗(yàn)統(tǒng)計(jì)結(jié)果皆顯示P0.05,差異有統(tǒng)計(jì)意義。因此,提示三才配穴組對(duì)原發(fā)性失眠的治療發(fā)生作用,使r-氨基丁酸、谷氨酸、5-羥色胺、去甲腎上腺素含量增加,乙酰膽堿、多巴胺含量降低。(2)ET組間比較r-氨基丁酸、谷氨酸、5-羥色胺、乙酰膽堿、去甲腎上腺素和多巴胺非經(jīng)非穴組和三才配穴組兩組治療前測(cè)量結(jié)果經(jīng)配對(duì)樣本t檢驗(yàn)統(tǒng)計(jì)結(jié)果顯示,P0.05,差異無統(tǒng)計(jì)意義,兩組具有可比性。兩組r-氨基丁酸、谷氨酸、5-羥色胺、乙酰膽堿、去甲腎上腺素和多巴胺非經(jīng)非穴組和三才配穴組兩組治療中、治療后測(cè)量結(jié)果經(jīng)配對(duì)樣本t檢驗(yàn)統(tǒng)計(jì)結(jié)果皆顯示P0.05,差異有統(tǒng)計(jì)意義。提示相對(duì)非經(jīng)非穴組,針刺三才配穴治療原發(fā)性失眠可以使r-氨基丁酸、谷氨酸、5-羥色胺、去甲腎上腺素含量增加,乙酰膽堿、多巴胺含量降低。結(jié)論:(1)針刺三才配穴治療原發(fā)性失眠療效顯著,針刺非經(jīng)非穴對(duì)原發(fā)性失眠治療影響不大。(2)針刺三才配穴治療原發(fā)性失眠后,可以使PSQI指數(shù)總分和各因子分值:睡眠質(zhì)量、睡眠時(shí)間、入睡時(shí)間、睡眠效率、催眠藥物應(yīng)用、睡眠障礙和日間功能障礙降低;且在治療結(jié)束后,具有遠(yuǎn)期效果。非經(jīng)非穴組治療后也可使PSQI指數(shù)總分降低,但對(duì)各因子分影響不大。提示三才配穴治療原發(fā)性失眠優(yōu)于非經(jīng)非穴。(3)針刺三才配穴治療原發(fā)性失眠后,可使ET檢測(cè)觀察的腦內(nèi)r-氨基丁酸、谷氨酸、5-羥色胺、去甲腎上腺素結(jié)果增加,乙酰膽堿、多巴胺降低,提示三才配穴在治療原發(fā)性失眠中有優(yōu)于非經(jīng)非穴組的趨勢(shì)。
[Abstract]:Objective: To study the Three Acupoints and non clinical curative effect difference non acupoint acupuncture treatment of primary insomnia, to test the efficacy of acupuncture treatment of insomnia with three is better than that of non acupoints, and to explore its effect on ET and PSQI, to provide guidance for clinical application. Methods: the research object of this project is the primary effective acupuncture primary insomnia patients, research method is used in randomized controlled trials (RCT). Based on the screening criteria included 72 patients with standard, with completely random grouping method is divided into two groups, Three Acupoints treatment group of 30 cases, 5 cases of loss; the non acupoint treatment group of 30 cases, 7 cases of loss. Treatment method three: the acupoints of Baihui group, Shenmen (double), Sanyinjiao (double), non acupoint group arm cloth and the acromion point. Patients with supine position, acupoint skin routine disinfection, 0.30mm * 25MM or 0.30mm * 40MM acupuncture acupoints, and in the side of the proximal end 0.5cm a 0.20mm * 13mm no 閽堝姞浠ヨ緟閽堜互鍔╅，

本文編號(hào)：1764218